Diogu Margaret Ifeoma, Lee Sze Chim, Del Pozo-Banos Marcos, Rouquette Olivier Y, John Ann
Population Data Science, Swansea University Medical School, Singleton Park, Swansea SA2 8PP, UK.
Population Data Science, Swansea University Medical School, Singleton Park, Swansea SA2 8PP, UK.
J Affect Disord. 2025 Sep 15;385:119394. doi: 10.1016/j.jad.2025.119394. Epub 2025 May 12.
Evidence of the negative impact of school absence and exclusion on children and young people's life trajectories has been growing but relevant population-based studies including suicide adjusted for history of mental health conditions are scarce. We aimed to examine the associations between suicide and school absence and exclusion.
We linked routinely collected electronic education and health data for pupils in Wales, UK during 2012/13-2018/19 school years. We identified pupils who were persistently absent or excluded from school and followed them up to identify suicide deaths to 31/12/2021. Firth logistic regression was used to evaluate adjusted odd ratios (aORs) of suicide mortality.
Respectively, 8.6 % and 4.3 % of pupils (N = 584,394) had records of persistent absence and exclusion from school. 123 pupils died by suicide in the cohort (21.0 per 100,000 persons). Adjusted odds ratios for suicide were 2.3 (95 % CI: 1.5-3.7) following exclusion but non- significant for persistent absence (1.0; 95 % CI: 0.6-1.7). Other indicators for suicide were male sex, age ≥ 10 years, history of self-harm, high levels mental health comorbidity, autistic spectrum disorders and drug use.
Relatively low numbers of suicide deaths reduced statistical power. There was no stratification of absence and exclusions into categories based on their nature or causes.
Long-term strategies to support those excluded from school, addressing their social, emotional and medical, needs should be implemented given their heightened risk of future suicide. Attendance data, routinely collected by schools, has potential to be developed as an indicator of unmet need.
关于缺课和被学校开除对儿童和青少年人生轨迹产生负面影响的证据越来越多，但针对包括根据心理健康状况史进行自杀调整的基于人群的相关研究却很匮乏。我们旨在研究自杀与缺课和被学校开除之间的关联。
我们将2012/13至2018/19学年期间英国威尔士学生的常规收集的电子教育和健康数据进行了关联。我们确定了持续缺课或被学校开除的学生，并对他们进行随访，以确定截至2021年12月31日的自杀死亡情况。采用费思逻辑回归来评估自杀死亡率的调整比值比（aORs）。
分别有8.6%和4.3%的学生（N = 584,394）有持续缺课和被学校开除的记录。该队列中有123名学生自杀死亡（每10万人中有21.0人）。被学校开除后自杀的调整比值比为2.3（95%置信区间：1.5 - 3.7），但持续缺课的情况不显著（1.0；95%置信区间：0.6 - 1.7）。其他自杀指标包括男性、年龄≥10岁、自伤史、高度心理健康合并症、自闭症谱系障碍和药物使用。
自杀死亡人数相对较少，降低了统计效力。没有根据缺课和被开除的性质或原因进行分类分层。
鉴于被学校开除的人未来自杀风险增加，应实施长期策略来支持他们，满足其社会、情感和医疗需求。学校常规收集的出勤数据有潜力发展成为未满足需求的一个指标。
